Active NPI
Shannon McNeill, PH.D.
- Clinical Psychologist
- Brockton, MA
National Provider Identifier
1467856906
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- PS01452
- Practice address
- 940 Belmont St
Brockton Vamc (116a)
Brockton, MA 02301-5596 - Phone
- (774) 826-2343
- NPI assigned
- Oct 13, 2014
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | PS01452 | RI | Primary |
Addresses
Primary practice location
940 Belmont St
Brockton Vamc (116a)
Brockton, MA 02301-5596
Mailing address
940 Belmont St
Brockton Vamc (116a)
Brockton, MA 02301-5596
Phone (774) 826-2343
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PS01452 | RI | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1413158400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1467072000000",
"number": "1467856906",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "940 BELMONT ST",
"address_2": "BROCKTON VAMC (116A)",
"city": "BROCKTON",
"state": "MA",
"postal_code": "023015596",
"telephone_number": "774-826-2343"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "940 BELMONT ST",
"address_2": "BROCKTON VAMC (116A)",
"city": "BROCKTON",
"state": "MA",
"postal_code": "023015596",
"telephone_number": "774-826-2343"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MCNEILL",
"first_name": "SHANNON",
"credential": "PH.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2014-10-13",
"last_updated": "2016-06-28",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "RI",
"license": "PS01452",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Brockton, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 28, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.